> The main source of savings in a single-payer system isn't simplified billing, but increased negotiating power on everything from drug prices to salaries.
You're agreeing with the parent's original point. Salaries in healthcare are far higher in the US than they are in eg the UK or Germany. The US median income is significantly higher than all but a few nations. In the US we don't ration care nearly to the extent that they do in eg Canada, wait times are lower and Americans over-use (abuse) their healthcare and always have.
In France a radiologist will make $150,000. In the US it's closer to $450,000. Nurses in the US will typically make 40%-50% more than nurses in Germany. Good luck hammering all of those pay scales back down without causing huge strikes.
You have to remove a trillion dollars in cost from the system. Only about $100b can be removed from big pharma's cost share. You have to destroy a million jobs (eg the health insurance industry), and slash the pay for hundreds of thousands of healthcare workers by at least 20% to 30%. Even if some of those lost jobs can eventually be reclaimed, the upheaval will be epic.
As typically understood, rationing is allowing each person to have a fixed amount of something no matter what. In the USA, if you want more healthcare, you have many options to increase your consumption. If you want to redefine rationing as anything that isn't yet post-scarcity, sure we have rationing.
Aside: Poor people do get health care in the USA. My brother was unemployed and received over $1 million in healthcare for his son with cancer, and hundreds of thousands of dollars in care for his dialysis treatment and eventual kidney transplant.
1 million in heathcare is still rationing. If say bill gates kid had cancer they would likely spend more money on care in the same situation.
But, as you say until we are post scarcity there is going to be cost benifit analysis. All I am saying is our current system is inefficient, I don't expect we are going to transition before the next revolution.
PS: A lot of government money ends up going to healthcare independent of patient care. Ex: HRSA Grants for Rural Heath systems add up to ~16 billion and are not counted as Medicare Medicare etc https://www.hrsa.gov/ruralhealth/
> Poor people don't get any health care, people with insurance get all the health care they want.
You just revealed that you don't know anything about the US healthcare system. Poor people have free healthcare in the US. It's the lower 20% to 40% income bracket that is getting particularly hammered. The top 50% have mostly good health coverage. The bottom 15%-20% is and has been covered by government healthcare for decades.
I'll repeat it again for emphasis: if you're at or below the poverty line, you get free healthcare in the US. See: Medicaid and several other connected programs that are built just for that and are very large. If you earn near minimum wage, you're going to qualify for free healthcare in pretty much every state. And it's actually decent healthcare.
edit: and I should clarify that yes, this is Medicare and not Medicaid and while I do understand the US medical system I'm not a health policy expert so I sometimes get specific points confused. Sheesh. Why does it take a PhD to figure out how to get medical coverage in the US?
You're agreeing with the parent's original point. Salaries in healthcare are far higher in the US than they are in eg the UK or Germany. The US median income is significantly higher than all but a few nations. In the US we don't ration care nearly to the extent that they do in eg Canada, wait times are lower and Americans over-use (abuse) their healthcare and always have.
In France a radiologist will make $150,000. In the US it's closer to $450,000. Nurses in the US will typically make 40%-50% more than nurses in Germany. Good luck hammering all of those pay scales back down without causing huge strikes.
You have to remove a trillion dollars in cost from the system. Only about $100b can be removed from big pharma's cost share. You have to destroy a million jobs (eg the health insurance industry), and slash the pay for hundreds of thousands of healthcare workers by at least 20% to 30%. Even if some of those lost jobs can eventually be reclaimed, the upheaval will be epic.